Vanessa P Ho1,2, Evelyn I Truong1, Saira Nisar3, Addison K May4, Gregory J Beilman5, Donald E Fry6, Philip S Barie7, Jared M Huston8, Jeffrey W Shupp3, Fredric M Pieracci9. 1. Department of Surgery, MetroHealth Medical Center, Cleveland, Ohio, USA. 2. Department of Quantitative and Population Health Sciences, Case Western Reserve University, Cleveland, Ohio, USA. 3. The Burn Center, Medstar Washington Hospital Center, Department of Surgery, Georgetown University School of Medicine, Washington, DC, USA. 4. Department of Surgery, Carolinas Medical Center, Atrium Health, Charlotte, North Carolina, USA. 5. Department of Surgery, University of Minnesota, Minneapolis, Minnesota, USA. 6. Department of Surgery, Northwestern University, Chicago, Illinois, USA. 7. Departments of Surgery and Public Health, Weill Cornell Medical College, New York, New York, USA. 8. Departments of Surgery and Science Education, Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA. 9. Department of Surgery, Denver Health Medical Center/University of Colorado School of Medicine, Denver, Colorado, USA.
Abstract
Background: Surgical research is potentially invasive, high-risk, and costly. Research that advances medical dogma must justify both its ends and its means. Although ethical questions do not always have simple answers, it is critically important for the clinician, researcher, and patient to approach these dilemmas and surgical research in a thoughtful, conscientious manner. Methods: We present four ethical issues in surgical research and discuss the opposing viewpoints. These topics were presented and discussed at the 39th Annual Meeting of the Surgical Infection Society as pro-con debates. The presenters of each opinion developed a succinct summary of their respective reviews for this publication. Results: The key subjects for these pro-con debates were: (1) Should patients be enrolled for time-sensitive surgical infection research using an opt-out or an opt-in strategy? (2) Should patients who are being enrolled in a randomized controlled trial (RCT) comparing surgery with a non-operative intervention pay the costs of their treatment arm? (3) Should the scientific community embrace open access journals as the future of scientific publishing? (4) Should the majority of funding go to clinical or basic science research? Important points were illustrated in each of the pro-con presentations and illustrated the difficulties that are facing the performance and payment of infection research in the future. Conclusions: Surgical research is ethically complex, with conflicting demands between individual patients, society, and healthcare economics. At present, there are no clear answers to these and the many other ethical issues facing research in the future. Answers will only come from continued robust dialogue among all stakeholders in surgical research.
Background: Surgical research is potentially invasive, high-risk, and costly. Research that advances medical dogma must justify both its ends and its means. Although ethical questions do not always have simple answers, it is critically important for the clinician, researcher, and patient to approach these dilemmas and surgical research in a thoughtful, conscientious manner. Methods: We present four ethical issues in surgical research and discuss the opposing viewpoints. These topics were presented and discussed at the 39th Annual Meeting of the Surgical Infection Society as pro-con debates. The presenters of each opinion developed a succinct summary of their respective reviews for this publication. Results: The key subjects for these pro-con debates were: (1) Should patients be enrolled for time-sensitive surgical infection research using an opt-out or an opt-in strategy? (2) Should patients who are being enrolled in a randomized controlled trial (RCT) comparing surgery with a non-operative intervention pay the costs of their treatment arm? (3) Should the scientific community embrace open access journals as the future of scientific publishing? (4) Should the majority of funding go to clinical or basic science research? Important points were illustrated in each of the pro-con presentations and illustrated the difficulties that are facing the performance and payment of infection research in the future. Conclusions: Surgical research is ethically complex, with conflicting demands between individual patients, society, and healthcare economics. At present, there are no clear answers to these and the many other ethical issues facing research in the future. Answers will only come from continued robust dialogue among all stakeholders in surgical research.
Entities:
Keywords:
ethics; informed consent; research; research funding; surgery
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